Men's Health: Understanding the Dangers of Infrequent Sexual Intercourse and the Definition of Premature Ejaculation

What are the harms of infrequent sexual activity?

Clinically, some individuals experience erectile dysfunction after months of abstinence due to illness (including a spouse's illness), marital discord, long-distance work, or separation.

Prolonged abstinence weakens the function of sex hormones. Therefore, sexual activity is a powerful means of stimulating sex hormones. Adequate androgen secretion plays a crucial role in maintaining a good appetite, muscle protein synthesis, muscle strength, and male sexual characteristics. It's incorrect to assume that sexual activity is unnecessary in old age. While the natural decline in sexual ability in older adults is gradual, self-satisfaction and self-suppression can artificially accelerate the atrophy and degeneration of sexual organs. In men, this can lead to penile flaccidity and atrophy, and soft, atrophied testicles, resulting in disuse erectile dysfunction. In women, it can accelerate vaginal atrophy, impaired blood circulation, and cause discomfort, pain, and dryness during intercourse. Simultaneously, the female vagina cannot absorb seminal plasma (which has a strong bactericidal effect) from male semen, making it prone to senile vaginitis. Furthermore, it is difficult to promote the sustained secretion of female hormones, thus accelerating the onset of menopausal symptoms and exacerbating their clinical manifestations.

Additionally, insufficient sexual intercourse and intentional suppression of sexual desire can lead to unfulfilled sexual desire, resulting in restlessness and agitation. In men, long-term abstinence from ejaculation can cause prostatic fluid to accumulate, leading to seminal vesicle congestion and potentially inducing benign prostatic hyperplasia. In middle-aged women, psychological repression of sexual desire can affect the normal secretion of ovarian sex hormones, causing menstrual irregularities, breast fullness and discomfort, decreased ovarian function, premature menopause, and dull, wrinkled skin. Therefore, insufficient sexual intercourse can have corresponding harms for both men and women.

What is Premature Ejaculation?

Premature ejaculation is the second most common male sexual dysfunction after erectile dysfunction, and it is also one of the most misunderstood aspects of normal sexual function.

According to a 1930s survey of 5,300 men by American sexologist Kinsey, 75% of them ejaculated within two minutes of penetration. A Chinese study of 234 elderly couples found that 43 couples (18.4%) had intercourse lasting less than two minutes. A 1990 study of 65 men aged 18-73, with no time limit, recorded any instances of premature ejaculation throughout their lives; 65% of them experienced premature ejaculation at some point in their lives. A 1994 study of 1,422 men aged 18-58, with a well-designed research approach, found that 29% had experienced premature ejaculation. This statistical estimate is relatively reasonable. This indicates that premature ejaculation is the most common male sexual dysfunction, both domestically and internationally.

Different people have different understandings of premature ejaculation, and patients' descriptions of it are often confused. Diagnostic criteria for premature ejaculation vary greatly, and a globally accepted definition has yet to be established. Research by sexologist Feather reveals that only 27% of women regularly achieve orgasm in intercourse lasting less than one minute, while 66% require more than 12 minutes. Feather argues that women need an average of about 8 minutes of intercourse to regularly achieve orgasm. Therefore, some have criticized the definition of premature ejaculation proposed by renowned American sexologists Masters and Johnson. They believe that "men cannot prolong ejaculation time to allow their partners to reach orgasm half the time during sexual intercourse." Judging premature ejaculation based on the partner's sexual satisfaction or the ability to achieve orgasm is clearly too strict and inconsistent, subjecting many men to the embarrassment of being diagnosed with "premature ejaculation," and is therefore unscientific. It will further lower men's self-esteem, damage marital relationships, and affect sexual harmony.

According to a survey of 1000 couples by American sexologist Gibbard, the average duration of intercourse was 4-7 minutes. A survey of 2709 people in my country, including 470 young adults and 2239 elderly individuals, found that the majority (approximately 20%) had intercourse lasting 5-6 minutes, 3-4 minutes, 7-8 minutes, and 10 minutes respectively.

However, what most people refer to as premature ejaculation is actually premature ejaculation, which doesn't actually last that long. So, how early is considered premature ejaculation?

Currently, most experts believe that premature ejaculation occurs when ejaculation happens before, during, or immediately after penetration, causing the penis to soften and preventing further intercourse. Some also consider premature ejaculation to occur within one minute of penetration, or after fewer than 15 thrusts. In summary, premature ejaculation is characterized by ejaculation occurring too early and too quickly after erection, thus affecting sexual life and mutual sexual satisfaction. However, it's worth noting that ejaculation lasting more than one minute but failing to reach female orgasm is often due to poor understanding, harmony, and coordination between partners. Unless the man is solely focused on his own sexual performance or lacks consideration and care for his partner, it invariably indicates inexperience in intercourse, a lack of understanding of coordination techniques, or insufficient mastery of sexual techniques.

Furthermore, whether the woman experiences sexual pleasure cannot be used to determine if the man has premature ejaculation. Female sexual pleasure is influenced by many other factors, such as the woman's emotions, the man's caresses, post-coital tenderness, and sexual position. The duration of intercourse is also closely related to age, physical condition, sexual experience, sexual position, penile thrusting amplitude and frequency, and the woman's sexual response. Even for the same person, the speed of ejaculation varies each time they have intercourse. For example, during the first sexual encounter after marriage, after a long separation, or after a period of abstinence, the man may ejaculate quickly due to excessive excitement, even premature ejaculation. This is completely normal and nothing to worry about. As the number of sexual encounters increases, it will adjust to a normal level. Furthermore, improving sexual skills through training and strengthening cooperation between partners can lead to mutual satisfaction and a harmonious sex life.